Over the past several years, we have been working on an important update to one of the most used tools in CBT practice, supervision, certification, and research trials: the Cognitive Therapy Rating Scale, or CTRS. The CTRS is a listing of 11 crucial components of CBT that must be performed in every session. These items are organized in two main categories: general therapeutic skills and conceptualization, strategy, and technique. The scale and manual were originally developed in 1980 by our co-founder, Dr. Aaron T. Beck, and Dr. Jeffrey Young.

In the 40+ years since the CTRS’s development, the practice of CBT has grown into one of the leading forms of psychotherapy across the globe. With so many people practicing and teaching this method, the CTRS has been invaluable in helping clinicians learn the essential components of effective CBT, which have held true over time. Yet the document needed some significant updates to give people more definitive instructions on how to rate the 11 items on the CTRS.

To illustrate this need, we ran an experiment with 45 trained CBT clinicians to evaluate the efficacy of the CTRS for use in CBT supervision. These clinicians watched a CBT session together, then individually used the CTRS to score the session. What we found was instructive: out of 45 different scorers, we received nearly as many different scores! This tool, meant to help clinicians and supervisors objectively evaluate the quality of a CBT session clearly and effectively, was clearly not doing its job.

So we developed a revised version of the CTRS, which we call the Cognitive Therapy Rating Scale (Revised), or CTRS-R. This document builds upon the previous CTRS and provides clearer descriptions and more specific criteria for each of the 11 original items. The CTRS-R provides very specific criteria, especially behavioral criteria, that therapists need to perform. For supervisors and others who rate CBT therapy sessions, it eliminates much of the subjectivity in scoring.

This tool is not just useful for CBT supervision. Clinicians can use the CTRS-R, and the corresponding CBT checklist that we developed simultaneously, to learn how to do CBT and practice their skills over time.

And you can watch a video of Beck Institute’s President, Dr. Judith Beck, speaking with me on the development of the CTRS-R:

We know that learning to do CBT well is a lifelong endeavor, and we are confident that the CTRS-R can help clinicians continually develop and refine their skills over time. We sincerely believe that this update will benefit countless clinicians and the field of CBT for years to come. 

Click here to learn more about the CTRS-R.